Reproductive health matters
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Reprod Health Matters · Nov 2013
Sustainable development goals for global health: facilitating good governance in a complex environment.
Increasing complexity is following in the wake of rampant globalization. Thus, the discussion about Sustainable Development Goals (SDGs) requires new thinking that departs from a critique of current policy tools in exploration of a complexity-friendly approach. This article argues that potential SDGs should: treat stakeholders, like states, business and civil society actors, as agents on different aggregate levels of networks; incorporate good governance processes that facilitate early involvement of relevant resources, as well as equitable participation, consultative processes, and regular policy and programme implementation reviews; anchor adoption and enforcement of such rules to democratic processes in accountable organizations; and include comprehensive systems evaluations, including procedural indicators. ⋯ It could structure and legitimize government involvement, engage stakeholders, arrange deliberation and decision-making processes with due participation and regular policy review, and define minimum standards for health services. A monitoring scheme could ensure that agents in networks comply according to whole-systems targets, locally defined outcome indicators, and process indicators, thus resolving the paradox of government control vs. local policy space. A convention could thus exploit the energy created in the encounter between civil society, international organizations and national authorities.
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Reprod Health Matters · Nov 2013
No risk, no gain: invest in women and girls by funding advocacy, organizing, litigation and work to shift culture.
The new development framework aspires to merge long-term hopes for environmental, political and financial sustainability with international poverty eradication goals. Central to this agenda is the promotion and protection of the human rights of women and girls. Yet national mechanisms, donors and international development agencies often do not fully tackle these issues or confront the accompanying politically sensitive, complex issues intermingling religion, socioeconomic status, social, cultural and family life. ⋯ Success will require support for a potent mix of advocacy, movement building and a complex set of ground-based strategies that shift cultural practices, laws and policies that harm women and girls. Funding for advocacy and interventions that hold firm on human rights is imperative, but given the conflicting loyalties of governments and public-private partnerships, reliance on either sector may be risky. An analysis of the status of women's rights work, infrastructure and donor support in Bangladesh and South Africa shows the need for vigilance and long-term investment in effective work.
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Reprod Health Matters · Nov 2013
Brazilians have different views on when abortion should be legal, but most do not agree with imprisoning women for abortion.
Unsafe abortions remain a major public health problem in countries with very restrictive abortion laws. In Brazil, parliamentarians - who have the power to change the law - are influenced by "public opinion", often obtained through surveys and opinion polls. This paper presents the findings from two studies. ⋯ The differences in their answers were enormous: the majority of respondents were against putting women who have had abortions in prison. Almost 60% of civil servants and 25% of medical students knew at least one woman who had had an illegal abortion; 85% of medical students and 83% of civil servants thought this person(s) should not be jailed. Brazilian parliamentarians who are currently reviewing a reform in the Penal Code need to have this information urgently.
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In this article, we highlight key considerations for better addressing sexual and reproductive health and rights issues within universal health coverage (UHC), particularly in the context of the post-2015 sustainable development agenda. We look at UHC as a health, development and health care financing issue, and its history. ⋯ Instead, it should be considered as a means to achieving broader health and development goals. A goal such as seeking to reach the highest attainable standard of health or maximizing healthy lives that is informed by a rights-based approach should be the aspiration for the post-2015 development agenda.
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Reprod Health Matters · Nov 2013
Embedding sexual and reproductive health and rights in a transformational development framework: lessons learned from the MDG targets and indicators.
This paper explores the intended and unintended consequences of the selection of MDG 5 as a global goal, together with its respective targets and indicators, and places what happened to MDG 5, and sexual and reproductive health and rights more broadly, into the context of the development model that was encoded in the MDGs. Over the last decade, as the MDGs increasingly took centre stage in development and their use evolved, they were inappropriately converted from global goals into national planning targets. This conversion was particularly detrimental in the case of MDG 5. ⋯ Looking forward, it is not adequate to propose an MDG+ framework based on the same structure. Sexual and reproductive health and rights must be placed back into the global discourse, using development to empower women and marginalized populations, and to address structural inequalities that are fundamental to sustained social change. The new development framework should include a strong narrative of social transformation in which fit-for-purpose targets and indicators play a role, but do not overtake or restrict the broader aims of advancing social, political, and gender justice.